Evaluation of sleep quality and engraftment in patients undergoing mobilization and hematopoietic stem cell transplantation.

Abstract

Purpose: The aim of this study was to evaluate the prevalence and predictors of poor sleep quality in patients undergoing stem cell mobilization and transplantation, and to investigate the relationship between sleep quality and post-transplant engraftment.

Methods: This prospective, observational study comprised 107 patients with hematopoietic stem cell transplantation. Pittsburgh Sleep Quality Index [PSQI], Hospital Anxiety and Depression Scale [HADS] and World Health Organization Quality of Life-Brief Version [WHOQOL] questionnaires were administered before and after transplantation. Mann-Whitney and Student's t-tests were used to compare means. Logistic regression was used to analyze predictors of poor sleep quality after transplantation.

Results: Of 107 patients [mean age 53.1 ± 13.6 years; 44.9% women], 46 [43%] had poor sleep quality before transplantation. There was a significant difference between baseline and post-transplant PSQI scores [p = 0.036]. Both the PSQI scores [5.3 ± 3.4 vs. 8.0 ± 4.2, p = 0.001] and the percentage of patients with poor sleep quality [35.7% vs. 75%, p = 0.007] increased after transplantation in allogeneic patients. The presence of engraftment, PNL and PLT engraftment time were similar in good/poor sleepers at baseline, respectively [p = 0.11, p = 0.523, p = 0.341]. There was no association between sleep quality and engraftment. The risk factors affecting poor sleep quality after transplantation were PSQI score at baseline and type of transplantation in logistic regression analysis.

Conclusions: There is an increase after allogeneic transplantation in poor sleepers. The presence of engraftment and engraftment times were similar between good and poor sleepers at baseline. PSQI score at baseline and type of transplantation were risk factors for poor sleep quality after transplantation.